OBJECTIVES: To estimate fatal and non-fatal acute cardiovascular event (CVE) costs among non-elderly commercially-insured hyperlipidemia patients in the US. METHODS: The Truven Health MarketScan Commercial Database was used to identify non-elderly adults (age ≥18-˂65) with hyperlipidemia with a new acute CVE (index event) from 2004-2012. CVE was defined as an inpatient stay with admitting diagnosis of acute coronary syndrome (ACS) [myocardial infarction (MI) or ischemic stroke (IS)], transient ischemic attack (TIA), unstable angina (UA), or inpatient or outpatient revascularization (coronary artery bypass graft [CABG] or percutaneous coronary intervention [PCI]) without an associated CVE diagnosis. An 18 month pre-index period excluded patients with prior CVE and variable-length follow-up described annual incremental (difference between hyperlipidemia patients who did and did not have a CVE) costs following an acute CVE.  First year and subsequent year (mean of years 2 and 3) costs were calculated. Eligible patients were linked to Social Security Administration master death files, which indicates the presence (or absence of) and date of death. RESULTS: